Question

Cellular Aberration
1. Risk assessment and screening procedure of Prostate

2. Relevant information based on:
a. Chief complaints
b. Functional patterns
c. Physical examination of patient cellular aberrations

3. Pathophysiologic mechanics of Cellular aberration
a. Solid tumors
b. Liquid tumors

Answer 1

Abbreation

Abbreatio means something that deviates from normal way

Cellular abbrations

An abnormal pattern of Cell growth of which exceeds its uncoordinated with that of the normal cell growth and persists in the same excessive manner after the cessation of the stimuli which evoked the change.

Risk assessment and screening procedure for prostrate

1.PSA (Prostrate Antigen Speicfic ) Test

• PSA is mostly found in semen, but a small amount is also found in blood.
• Serum PSA normal level is usually > 4 ng/ml
• With increasing PSA level, chance of getting cancer increases, but less likely to be organ confined.
• PSA level between 4 and 10 is called the “borderline range , have about a 1 in 4 chance of having prostate cancer.
•   If the PSA is more than 10, the chance of having prostate cancer is over 50%.
• The PSA may also increse in the following cases

-An enlarged prostate:

-Older age

-prostitis

Ejaculation

-Medications suchtestosterone,5-alpha reductase inhibitors, thiazide diuretics, aspirin

2,Digital rectal examination (DRE).

• Prostate cancers often begin in the back part of the gland, and can sometimes be felt during a rectal examination.
• In thi sprocedure physician inserts lubricated finger into the rectum to feel for any bumps or hard areas on the prostate

3.Gleason score

• The samples of tissue from the biopsy are studied in a laboratory.
• If cancerous cells are found, they can be studied further to see how quickly the cancer will spread. This measure is known as the Gleason score.
• A Gleason score of six or less means the cancer is unlikely to spread.

CHIEF COMPLAINTS

• Weak or interrupted urine flow
• Blood in urine
• Nocturia
• Dysuria
• Pain in Pelvis, spine and ribs
• Lymphedema
• Renal insufficiency

FUNCTIONAL PATTERNS

The functional patterns depends up on the stages of prostrate cancer

1.EARLY STAGE

• Asymptomatic and patient will be able to funstion normally
• Cancer is in the peripheral zone

2. LOCALLY ADVANCED DISEASE

•During this stage they patients functioning will be slightly declined than the normal level

presence of symptoms include.

• Obstructive / irritative voiding including  Hesitancy , Intermittent urinary stream , Decreased force of stream

• Retention of urine

• Hematuria

• Hematospermia

• Renal failure

• Pelvic pain

3. ADVANCED DISEASE

•funtioning level is limited and hospitalisation needed

•spread to the regional pelvic lymph nodes

• Edema of the lower extremities

• Pelvic and perineal discomfort

4.METASTATIC DISEASE

• Bone pain

• Spinal cord compression symptoms

• Paraperesis

• Hematuria

• Hematospermia

• Constipation

• Intermittent diarrhoea

• Abdomino-pelvic pain

. • Fluid retention/ electrolyte imbalance

PHYSICAL EXAMINATION OF PATIENT WITH CELLULAR ABREATIONS

1. Genaeral assessment

• Head to toe examination will be dne in general physical examination

INSPECTION

• Overall appearance of health or illness

• Signs of distress

• Facial expression and mood

• Body size

• Grooming and personal hygiene

PALPATION

• Palpate the body surfaces for the presence of masses that indicate the presemnce of tumours
• Encourage the patient to continue to breathe normally throughout the palpation.
• If pain is experienced during the palpation. discontinue the palpation immediately.
• Inform the patient where, when, and how the touch will occur, especially when the patient cannot see what you are doing.

ASCULTATION

• Using a stethescope ascultae fo rthe presence of abnormal breath sounds and heart rate
• Examine for

1.Pitch (ranging from high and low):frequency or number of oscillations generated per second by vibrating object

2. Loudness (ranging from soft to loud): amplitude of sound

3. Quality (gurgling or swishing)

4. Duration (short, medium or long)

Percussion

• It is used to find  density of a part by tapping the surface with short, sharp blows and evaluating the resulting sounds.
• Depending on the sounds that are produced by tapping over your abdomen, on your back or chest wall, your healthcare provider may determine anything from fluid in your lungs, or a mass in your stomach.

2. Pain assessment

• Can be done by numerical scale, visual analogue scalle, brief pain invemntory

3.Neurological Assessment Measure

PATHOPHYSIOLOGY OF CELLULAR ABBRATIONS

• Solid cell turning into a annormal disease cell
• Proto-oncogenes are qualities that are coded to keep up typical cell development. Oncogenes are a quality that has changed to influence the cells to develop and isolate quicker.
• In growth cells the cell develops and separates rapidly.
• then abnormal cells turn into a malignancy cell
• DNA repair qualities getsaffected
• DNA repair qualities enable your sound cells to know whether something isn't right with its DNA and how to settle it.
• At the point when these qualities get killed the cell doesn't know whether it is wiped out, and it can't settle any issues with its DNA.
• Metastasis is the tendency of tumor cells to be carried from their site of origin by way of the circulatory system and other channels, which may eventually establish these cells in almost every tissue and organ of the body.

SOLID TUMOUR

• Solid tumour is an abnormal mass of tissue that usually does not contain cysts or liquid areas. S
• It can be benign or malignant
• Cells of a solid tumor do not all present the same mix of antigens on their surfaces
• Solid tumors produce immune-suppressing agents such as the checkpoint molecule PD-L1.
• The cells of a solid mass  thousands of layers thick is difficult for T cells to infiltrate.
• Eg ;sarcomas, carcinomas, and lymphomas. Leukemias (cancers of the blood) generally do not form solid tumors.

LIQUID TUMOURS

• These includes the cancers of bone marrow and hemotologic system.
• The disease is often associated with the overproduction of immature white blood cells

it incluses

• Myelogenous or granulocytic leukemia (malignancy of the myeloid and granulocytic white blood cell series)
• Lymphatic, lymphocytic, or lymphoblastic leukemia (malignancy of the lymphoid and lymphocytic blood cell series)
• Polycythemia vera or erythremia (malignancy of various blood cell products, but with red cells predominating)